ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of diacerein in patients with knee osteoarthritis (OA).</p><p><b>METHODS</b>A total of 223 patients satisfying the American College of Rheumatology criteria for knee OA were chosen for this 17-week, randomized, double-dummy, diclofenac sodium-controlled trial, with diacerein dosage of 100 mg/d and diclofenac sodium of 75mg/d. Efficacy and safety of both drugs were evaluated.</p><p><b>RESULTS</b>Totally 106 patients in the diacerein group and 107 patients in the diclofenac group were considered qualified for the evaluation. After 12 weeks of treatment, the total effective rates of patients/physicians' overall assessment in diacerein and diclofenac groups were 65.4%/61.6% and 61.2%/61.2%, respectively (P > 0.05). The primary efficacy parameter [visual analog scale (VAS) assessment of pain on 20 metres walking] and the secondary efficacy parameters [tenderness on palpation, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and 36-item Short-Form (SF-36) Health Survey] significantly improved compared with baseline in both groups (P < 0.05). In the follow-up period, there were no obvious changes in above parameters in diacerein group. However, in diclofenac group, pain on 20 metres walking, tenderness on palpation, and WOMAC became aggravated after withdrawing the drug for 4 weeks (P < 0.05). Moreover, the consumption of paracetamol was significantly lower in diacerein group than in diclofenac group during follow-up (P < 0. 001). The incidences of related adverse events were 35.7% in diacerein and 45.1% in diclofenac group, respectively. Mild-to-moderate gastrointestinal disorders were the most frequent adverse events.</p><p><b>CONCLUSIONS</b>Diacerein is as effective as diclofenac sodium in treating patients with knee OA. Furthermore, it has better extended effect and a good safety profile. It is generally well tolerated and has no severe adverse effect.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Anthraquinones , Therapeutic Uses , Anti-Inflammatory Agents, Non-Steroidal , Therapeutic Uses , Diclofenac , Therapeutic Uses , Double-Blind Method , Osteoarthritis, Knee , Drug Therapy , SafetyABSTRACT
Objective This research is proposed to improve the recognition of the clinical features, therapy and prognosis of palindromic rheumatism.Methods We analyzed the clinical data of 63 palindromic rheumatism patients.Their response to therapy was observed,and they were followed up for 1.5 to 3 years. Results The average onset age of the patients was(40?11)years and the average disease duration was(8?7) years.They were characterized by recurrent attacks of sudden-onset acute arthritis and(or)periarticular tis- sue inflammation,in which most joints were involved.In 46 percent of the patients,the attacks were incited by some events.In 67 percent of them,the attacks recurred more and more frequently.Nonsteroidal anti-in- flammatory drugs and disease modifying anti-rheumatic drugs(DMARDs)was effeeive in variant extents,to palindromic rheumatism patients.Five percent of patients achieved complete remission.Nine percent of them had relapses for a long time.And 5% of them evolved to RA.Conclusion Palindromic rheumatism is a syn- drome characterized by recurrent attacks of sudden-onset acute arthritis and(or)periarticular tissue inflam- mation.The therapy of DMARDs,especially penicillamine and chloroquine diphosphate,is effective on the syndrome.The outcomes of palindromic rheumatism is diverse.
ABSTRACT
Objective To evaluate the efficacy and safety of diacerhein in the treatment of patients with knee osteoarthritis.Methods The efficacy and safety of diacerhein was randomly investigated in 42 pa- tients with knee osteoarthritis using parallel group methodology and a double-dummy technique to ensure dou- ble blind status with respect to diacerhein and control drugs diclofenac.Results Significant changes were ob- served in 20 meters walk pain,knee joint tenderness scale,WOMAC index scale,5F-36 health survey,knee joint swelling scale,compared with baseline(P＞0.05)in both diacerhein and diclofenac group respectively.No difference was found between diacerhein group and diclofenae group.The patient global assessment and physi- cian's global assessment were similar in diacerhein group and diclofenac group(P＞0.05).The side effect was similar in two groups.All of these side effects in gastrointestinal tract appeared to be transient.Conclusion Diacerhein can effectively relieve pain and swelling of knee osteoarthritis,and provides us a new effective and safe approach for treating knee osteoarthritis.
ABSTRACT
Objective To investigate the etiological factors, clinical features and prognosis of non- traumatic rhabdomyolysis(RML). Methods The medical records of 13 non-traumatic RML patients hospital- ized between 1995-2006 were reviewed. The etiological, clinical, laboratory and therapeutic data were anal- ysed. Results Among 13 patients with non-traumatic RML, multiple factors were responsible for rhabdomyol- ysis in eight patients and single etiologic factor in 5 patients. Different etiological factors were identified, in- cluding 6 with excessive exercise, 3 with hyperpyrexia, 3 with drugs(including illicit drugs, fenofibrate, cy- closporine), 3 complicated with inflammatory myopathy and 2 with limbs compression. Nine patients had myal- gia and muscle weakness, 6 patients had abnormality in nervous system, 4 patients had hyperpyrexia, 3 pa- tients had digestive symptoms. Nine patients were complicated by coagulation disorders and 6 with acute renal failure(ARF). The serum levels of creatine kinase(CK)were decreased to normal within one month in 6 patients, the patient whose rhabdomyolysis was induced by fenofibrate with diabetes and chronic renal failure showed to inadequate decrease within 60 days. Three patients whose problem was induced by inflammatory myopathy, CK levels decreased within 4 months and 6 months in 2 patients, respectively, but CK level was not returned to normal level in one patient during the 80 follow-up days. Three patients died from multiple causes, such as ARF, coagulation disorders,electrolyte and metabolic disturbances. Conclusion Excessive exercise is the most common cause of non-traumatic RML, followed by drugs and inflammatory myopathy. The prognosis is poor in patients with multiple etiological factors and ARF.